This leaflet is provided by the Royal College of Psychiatrists, the professional body responsible for education, training, setting and raising standards in psychiatry. They also provide readable, user-friendly and evidence-based information on various mental health problems.

The aim of this leaflet is to help you decide about when and how to come off antidepressants.

Some people find coming off antidepressants is quite easy. But others may get withdrawal or a return of the depression.

We asked people to tell us what it was like for them to come off antidepressants. This leaflet brings together the views of the 817 people who completed our survey and shared their experiences.

Survey findings

In our survey, the most common drug stopped was citalopram. This was taken by 235 people. Fluoxetine was next, taken by 173 people, followed by venlafaxine (109), sertraline (89), escitalopram (51), mirtazapine (38), paroxetine (29) and duloxetine (26).

36% stopped their antidepressant suddenly. Males were more likely to do this (m=44%, f=34%). Younger people were also more likely to stop suddenly (59% of 18-24 year-olds compared with just 20% of the over-65s).

512 (63%) people in our survey experienced withdrawal when stopping their antidepressants.

Some drugs were more likely to cause withdrawal than others. In the table below we have split the drugs into 3 groups (high, medium and low withdrawal).

High

Medium

Low

% withwithdrawal

% withwithdrawal

% withwithdrawal

Venlafaxine

82%

Sertraline

62%

Fluoxetine

44%

Escitalopram

75%

Citalopram

60%

Mirtazapine

21%

Paroxetine

69%

Duloxetine

69%

A further 43 people were on tricyclic antidepressants. 53% of them had withdrawal. 23 people were on other types of antidepressant, but the individual numbers on these drugs were too small to be able to draw conclusions.

Common withdrawal symptoms

Overall, the most common symptoms were:

anxiety (70%)

dizziness (61%)

vivid dreams (51%)

electric shocks / head zaps (48%)

stomach upsets (33%)

flu-like symptoms (32%)

depression (7%)

headaches (3%)

suicidal thoughts (2%)

insomnia (2%)

Anxiety was the most common symptom for every antidepressant except duloxetine, for which 'dizziness' was the most common. The least common symptoms across all types were stomach upsets and flu-like symptoms. These patterns were the same for men and women.

Why do people stop?

The people in our survey decided to stop for a number of reasons:

Reason for stopping

Number of people

Felt better

219

Side-effects

213

Didn’t help

175

Wanted to try without

45

Pregnant

39

On advice of doctor

21

When to stop?

Deciding when to stop is really important.

If you have had one episode of depression, you are usually advised to stay on antidepressants for 6 months to 1 year after you feel better. If you stop too soon, your depression may come back.

If your problems have been going on for some time, your doctor may advise you to stay on antidepressants much longer.

It is important to be aware of two things if you do stop:

You may get withdrawal.

The condition for which you were taking your antidepressants may come back.

Seeking advice

We strongly advise that your decision to stop is made with your doctor.

In our survey:

372 people got advice from a professional

95 from the internet

75 from the information leaflet provided with their pills

35 from someone who had stopped antidepressants

289 did not seek advice

A quarter of people in our survey were not aware that there could be problems linked with stopping.

What is withdrawal like?

People in our survey reported that the symptoms generally lasted for up to 6 weeks. A small percentage of symptoms lasted longer than this. A quarter of our group reported anxiety lasting more than 12 weeks.

Of the common symptoms reported, the one rated severe by most people was anxiety. The symptoms that were rated moderate by most people were stomach upsets, flu-like symptoms, dizziness, vivid dreams and electric shocks/brain zaps. The less common symptoms were reported as severe: returning depression, headache, suicidal thoughts, insomnia, fatigue and nausea.

Sources of information suggested by our responders

Final comments

63% of people in our survey said they had experienced withdrawal or a return of depression. This is a higher figure than other research suggests (about 30%). It is possible that the research has underestimated the problem, but it is also possible that people were more likely to respond to our survey if they had problems stopping.

Either way, we hope that you find the advice given in this leaflet useful.

We would also like to reassure readers that despite some people having symptoms of withdrawal when stopping antidepressants, antidepressants are not addictive.

Content used with permission from the Royal College of Psychiatrists website: Coming off antidepressants (October 2014, due for review October 2017). Copyright for this leaflet is with the Royal College of Psychiatrists.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.